


The Life and Times of Starfleet Medical

by sad_bi_cowboy



Series: ST Bingo 2020 [5]
Category: Star Trek, Star Trek: Alternate Original Series (Movies)
Genre: Academy Era, Bones is a Long Suffering Resident, Gen, Medical Procedures, Slice of Life, Star Trek Bingo Summer 2020, Starfleet Academy, Starfleet Medical
Language: English
Status: Completed
Published: 2020-09-01
Updated: 2020-09-01
Packaged: 2021-03-07 01:26:49
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 4,026
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/26238583
Author URL: https://archiveofourown.org/users/sad_bi_cowboy/pseuds/sad_bi_cowboy
Summary: Bones adjusts to life as an Academy student and a resident at Starfleet Medical.Basically: what would Starfleet Academy look like for Bones, who has already graduated from medical school and is a resident at the time we and Jim meet him in the shuttle?Written for the "Academy Era" square on my Bingo card.
Series: ST Bingo 2020 [5]
Series URL: https://archiveofourown.org/series/1905787
Comments: 5
Kudos: 43
Collections: Star Trek Bingo Summer 2020





	The Life and Times of Starfleet Medical

**Author's Note:**

> The ONLY two valid moments in Star Trek Medicine is when Bones slaps the lady in the face in that one episode and the time that Julian just straight up yanked Miles' shoulder back into place when he dislocated it. Other than that it's all BULLSHIT lmao.

Leonard was abruptly and rudely awakened by the sound of the front door hissing open, followed by the dull  _ thunk _ of a body running into the doorframe on the way in. He groaned loudly and rolled over, hoping that for once Jim would go to sleep without choosing to drunkenly pester him. A knock on his bedroom door proved that hope was in vain. 

“What, Jim?” he grumbled, sitting up and rubbing his eyes. Jim opened the door and came in, promptly flopping facedown on the foot of his bed and mumbling something into the bedding. 

“Jim I can’t hear ya. Speak up for christ’s sake.” 

“I said do you have one of those hangover hypos?” he slurred. Leonard gave a long-suffering sigh. 

“No I don't, I'm fresh out,” he said. “Take ibuprofen, chug a sports drink, and go to sleep like a normal person.” 

“Booooooooones,” Jim complained. Even in the dark, Leonard could see the dark purple hickies lining Jim’s throat and jawline. Where he got the energy for this, Leonard had no idea. He shoved him out of bed onto the floor. 

“Go to sleep, you infant. I’m on early tomorrow and I’m pullin’ a double. So if you don’t mind gettin’ out of my room, I’ll be goin’ back to sleep now.” 

Jim grumbled about being shoved but managed to stumble to his feet and presumably (hopefully) back to his own bed. Damn him and his free weekends. Leonard bunched his pillow into a more comfortable shape and fell back asleep. 

His second rude awakening came with the blaring of his alarm at 05:00. He hit snooze before deciding that that would be a bad decision - he needed his coffee, otherwise he would be hating himself as noon hit. He located a pair of clean scrubs after brushing his teeth and combing his hair before shuffling out into the small common area he and Jim shared. 

They had been living together for almost two months - since they had met on the shuttle to San Francisco. Leonard still had a measure of disbelief that he had done something so big and impulsive. Even so, it had been simple enough to make arrangements to move his stuff after arriving at Starfleet Academy and to get his privileges transferred to Starfleet Medical. He was a fully licensed and qualified doctor after all. There was, of course, the minor snag of him having left Mississippi in the middle of his residency, but even that had been sorted out after a conference call with the Starfleet Medical residency director and his attendings and supervisors at Ole Miss.

Jim had complained about his comparatively light course load when they compared schedules after registration. Leonard had promptly whacked him upside the head with a rolled up paper.

“I didn’t make a stupid bet with Christopher Pike to finish in three years, idiot. And unlike you, Genius Level Repeat Offender, I already have multiple degrees and a medical license to my name.”

“Unfair!” Jim declared. 

“I’m six years older than you, it’s perfectly fair. I’ve done all this ‘college’ stuff already. And besides, I’m workin’ at the hospital so I can finish residency, so I don’t have  _ time _ to have your schedule.”

Jim’s face had lit up as his two brain cells finally aligned to produce a thought .

“Yeah but you’ll still have to go through all the training for space, just like the rest of us.” 

“Don’t you remind me. The flight here was bad enough, and we didn’t even leave the atmosphere.” 

“I can’t wait to see you in the gravity simulator,” Jim had said, a shit-eating grin taking up his entire face. 

Grimacing at the memory of his first time in the simulator the month before, Leonard pulled out a clean travel mug and adjusted the settings on their coffee maker. He let it brew while he rummaged in the pantry for breakfast, deciding on a bagel. He toasted it and dug the cream cheese out of the fridge.

He slung his bag over his shoulder, grabbed his coffee and bagel, and headed out into the hallway of their ‘Fleet apartment block. He had always liked early morning shifts, and had grown particularly fond of the morning walk from their place to the hospital. His love for morning shifts had actually worked out in his favor because it allowed him to work for a few hours before his classes during the week. 

The ER was, unsurprisingly, already bustling when he walked in. Saturday mornings tended to be rife with the unfortunate victims of Friday nights - 16-year-old cadets taken out on the town by their older buddies, drunken falls, humans who tried some strange alien alcohol or drug (and vice versa), and inter-species hookups gone wrong. 

Leonard loitered by the admit desk for a few minutes to talk to a few of his colleagues coming off the night shift before he headed upstairs to the surgical floor. Technically, he was a resident in the trauma surgery department, but Starfleet ran their residencies a little bit differently than other programs. Instead of a sole focus, residents chose a main specialty but were expected to spend every other month on rotation. His rotation had been the month before, so he was solely on the surgical service for now.

“Hey Len.” He looked around his locker door to see Setaa, a 4th year resident, come in and start rummaging through her locker. 

“Hey,” he said, sliding his medical tricorder into his scrub pocket. “Long night up here? The ER is a zoo.” 

Setaa twitched her antennae - the Andorian equivalent of a shrug. 

“It wasn’t that busy actually. We had one really bad hovercar wreck come in from Sausalito, but other than that the ER mostly kept to themselves.” 

“I don’t know if that’s an omen for me or not,” Leonard said. “I’m on a double today. I told Marley I’d take her afternoon because her husband is comin’ home for a conference.” 

“Oh, Mateo’s coming this weekend?” she asked. 

“Yeah, you didn’t know?” 

“No. I guess I haven’t seen Marley for more than thirty seconds for a while. Our shifts ended up opposite when she came back from rotation.” She grabbed a spare shirt out of her locker after stripping off her scrub top. “I’m glad they get to see each other. I can’t imagine having a mate that’s stationed almost on the other end of the quadrant.” She pulled on what looked like some sort of athletic wear. “I have a sparring session in half an hour, so I have to run. Have a good shift, Len.” 

“Thanks Setaa. Have a good spar. Don’t end up here as a patient like you did last time.”

“That was a fluke and you know it. I ended up having the Academy Plague, for your information.”

“Yeah yeah,” Leonard snorted. “See you in class on Monday.” He followed her out the door and went to look at his schedule for the day. The trauma service tended to be at the mercy of the ER, but they still scheduled their residents to assist other surgeons in planned surgeries to keep them well rounded. He turned out to be covering the ER for his first shift and being turfed over to ortho for the second, so he headed back downstairs.

Unfortunately, the curse still ran strong, and equivalent exchange ruled that since Setaa had had a slow night, the morning would be hell for the day shift. Leonard ended up running three codes, taking on two major trauma cases from an Academy piloting class gone horribly wrong, and generally being at the beck and call of the ER staff, specifically the brand new interns. Fresh out of med school, they needed a little more hand holding than he would like. By the time 1400 rolled around, he was grateful to finally finish helping a nervous-looking Vulcan intern with his deep suture technique and make a beeline for the ortho unit. 

The general archetype of orthopedic surgeons hadn’t changed much over the past 300 or so years. Most reminded him of Jim: mildly arrogant, loud, boisterous, jock-types. Even the three Vulcans on the unit were like that, in their own, Vulcan way. The head of ortho was Dr. Aleksandra Yahontov, the ex-CMO from the decommissioned  _ USS Markovnikov _ (yes she recognized the irony). She had played on the rugby team at the Academy in her day, and she had not lost her athlete ways in the intervening years; she was built like a fucking brick shithouse, with a full tattoo sleeve on her right arm and so much metal in her ears it was a wonder she could be in the same building as an MRI. 

Leonard always had a great time with ortho. Everyone was just so damn friendly, and he had a knack and a fondness for orthopedic procedures. Yahontov made it a point to say that she thought he should have concentrated on ortho instead of trauma surgery every time he worked with her. 

“McCoy, if you keep this up I might have to do something unsavory and steal you from Kamau,” she said to him over a shattered tibia. Kamau was the head of the trauma department, a wizened space veteran himself who had served on the  _ USS Pensacola  _ for most of his tenure.

Leonard picked out a small, dissolvable bone screw and loaded it into the drill. 

“Not to bang my own drum, Yahontov, but I think Kamau would only give up one of his most promisin’ third years over his dead body.” He found the sturdiest area on the fragment of bone he was working on and started drilling. These screws would fuse with the re-growing bone tissue within a few days. This, along with a few treatments under the bone-knitter, the person they were working on would be up and walking in about ten days. 

Yahontov snorted as she further examined the proximal end of the leg. 

“Feeling awfully sure of yourself there, cadet,” she said. Leonard fake swooned. 

“You  _ wound _ me!” he said. Attendings often ribbed the residents by calling them cadets. They were, but being a doctor tended to supersede rank. “I thought you orthopods liked to be sure of yourselves.” He scanned over where the screw was to check the placement. Satisfied, he moved on to searching the surrounding tissue for any stray bone pieces. 

“You laugh at us, but trauma is exactly the same,” Yahontov said, realigning two pieces with a loud  _ crack _ . “Except maybe with bigger God Complexes. You know, holding life and death in your hands, all that. Hand me that drill, will you?” Leonard handed it across the table. 

“Maybe I’ll ask to be assigned to y’all more often,” he said. “They like when third years take initiative. I might even bring y’all a new med student to pick on.”

“Oh are you getting one?” she asked, checking the polymer plate holding the two pieces together before reaching for the microfiber sutures and handing them to him. “You close.” 

“I hope,” Leonard said. “The third years are starting their clerkships soon. I’ve always liked supervisin’ med students, so they just gave them all to me when I was at Ole Miss.”

“Is it for the power trip?” asked Yahontov. Leonard looked up from where he was closing the muscles. 

“Maybe just a little bit.”

~~~~~~

“Ow! Ow!” 

“Jim hold the fuck  _ still _ ,” Leonard snapped, reaching for a sedative. “I’ll put you out and get this shoulder back in place, but I have to make sure you won’t die if I do it.”

Jim had been brought in by Captain Pike himself after going right when he should have gone left during a sparring match and ripping his shoulder out of its socket (and probably ripping all of his ligaments in half along with it). 

“Did they teach you bedside manner when you were in med school?” Jim groaned. Pike sat in a chair next to him looking at a PADD, looking thoroughly unperturbed by Jim’s whining. 

“No, we do it differently in the country,” Leonard said dryly, scanning over Jim’s bio readouts. “Okay, I think you won’t die if I sedate you.” 

“You  _ think _ ?!” Jim squeaked as he was jabbed with the hypo.

“I’m jokin’, you infant. Now count some sheep and when you wake up your arm’ll be back in place. I can’t say anythin’ about the lack of brain cells, but I’m just a simple country doctor. I can only do so much.” 

“Asshole,” Jim mumbled as he fell asleep. 

“Mmmhmm,” Leonard responded. He walked over and poked his head out of the cubicle. “Hey, Rodriguez, can you come and help me in here?”

Jim’s shoulder went back in without much of a fuss (Pike turned a little green when the joint cracked back into place) and Leonard took some scans and sent them off to radiology for reading. He turned back to Pike.

“Captain, just press this button when he wakes up. He’ll probably have to go to ortho tonight and get everythin’ sewn back together, so I’ll come back to get him all set up,”

Pike casually saluted him. 

“Will do. Thanks doctor.” 

Still feeling awkward giving any sort of order to a captain (he really would have to get over that), Leonard left to go and finish updating Jim’s substantial medical file that he had been working on over his past year at the Academy. He was sort of proud to say he had a record of his own: a broken nose from a wild elbow during hand-to-hand his first semester, a torn ACL, PCL, and MCL from a bad day at the climbing walls, and a ruptured spleen from a particularly overzealous Caitian - also during hand-to-hand - among a few others. 

The number of purely academic Starfleet classes that he was required to take had dropped off significantly this year, but the training ones had not - they were, afterall, training for space travel, so he had a few more injuries to look forward to. As far as the Medical Corps went, they had their own set of requirements and classes in addition to the normal Starfleet curriculum, but since the program at Ole Miss had been a total of seven years - five in the classroom, which combined a biochemistry degree with the first years of med school and two rotating between hospitals on different Federation worlds to finish his medical degree - he had managed to get out of most of them. The major ones he was taking were a few advanced xenobiology courses as well as “Starship Medical Management,” “Advanced Wilderness Medicine,” and “Exoepidemiology.” The last one focused on the spread of disease through space and on starships - problems faced by all space-faring species, as an outbreak of even the common cold in an enclosed space could wreak havoc on the normal functioning of a ship. 

The buzz of his pager alerted him that Jim was waking up, so he went back to the room to make sure he didn’t do anything stupid. Luckily, the kid had enough sense to not mess with the sling on his arm - that, or he was still drugged out. Either way, Leonard was thankful for it. 

“Jim, you’re goin’ up to ortho to get sewn back together,” he announced. Jim groaned. 

“Bones, can’t you just do it down here and then I can go home? I don’t want to spend the night.”

“Why? Hot date?” Jim looked sheepish when he asked this. Leonard heard Pike give a small, exasperated sigh. “Unbelievable. Jimbo I’m sorry but it looks like you’re gonna have to postpone your date. I can’t do it because you’ve ripped pretty much everythin’ to shreds, and it’s gonna take more time than just a minor procedure for one ligament. And besides, you’ll be on limited use for at least a week.” 

Jim gave his best shit-eating grin.

“That doesn’t mean I can’t just lay there.” 

Pike put his face in his hands and pressed on his temples. Leonard wanted whack Jim with his PADD. 

“Disgusting,” he said, making sure to enunciate. “When was the last time you ate or drank anythin’?”

“I had some water about 45 minutes ago,” Jim replied. “But I didn’t have anything else, and the last time I ate was three hours ago.” Leonard made some notes in the PADD he was going to send upstairs with Jim. 

“Okay, I’ll tell ‘em to fast you for the next three hours, and then they’ll take you in. I’ll pick you up after and take you home tonight.” 

“Awww Bones, too nervous to come in with me,” Jim cooed, giving him his best doe-eyes. 

“No idiot, I took time out of my day to come patch up your dumb ass. I’m on rotation with cardiology for the next two weeks, and they would like me to continue gracin’ them with my presence.” 

“Poor cardiology,” Jim said. Leonard shook his head. 

“Anyway, you’re all set to go up. I’ll have people come and get you and then I’ll see you later tonight.” 

“Thanks Bones,” Jim said (he knew when to be nice), taking his hand and squeezing it. 

“Don’t mention it,” Leonard responded. “Captain.” He cocked his head at Pike. 

“Doctor.” 

~~~~~~

“I don’t know why you want me to be there,” Leonard said to Jim across their table.

“I just want my best friend to help support me for the test,” Jim said. “What do you think, Jo? Should your daddy help me out?” 

“Yes!” Johanna exclaimed from her chair. 

“Jo, you’ve betrayed me!” Leonard said, dramatically falling over the back of his seat. “I thought you were on my side?” 

“Daddy, you always tell me I need to be nice. You’re not being very nice to Uncle Jim.” 

Jim nearly busted his gut laughing and then proceeded to choke on his cereal. Leonard sighed. 

“Out of the mouths of babes, I guess. You’re right Jo, I wasn’t bein’ very nice to Uncle Jim. So that means I  _ will _ be helpin’ him with the  _ Kobayashi Maru _ , I guess.” 

Jim took a huge gulp of air. 

“Thanks for helping me out, JoJo,” he said. 

“I should’a never introduced the two of you,” Leonard grumbled, gathering up his and Johanna’s bowls and putting them in the sink for later. “Come on Jo, get your bag and put your shoes on. We need to leave or we’ll be late for class.” Johanna scampered off to find her bag. 

When Johanna had first visited, Jim had teased Leonard for taking her to class with him. 

“I can’t believe my best friend is raising a nerd,” he’d said. 

“Jim you are  _ literally _ a quantifiable genius. If anyone is a nerd in this household, it’s you. And besides, Johanna likes coming to class. It makes her feel all grown up.” What he hadn’t said was that he would read out his study material to her when she was a baby and he was in med school; that would just prove Jim’s point.

“What do you have today?” Jim asked him around another mouthful of cereal. 

“This mornin’ I’ve got Xenoimmunology and after lunch I’m supervisin’ a surgical techniques lab for some second year med students. She’s excited for the lab; she has a little suture practice pad that she works on while I strike fear into them.” 

“Somehow I’m not surprised that you have your seven-year-old already semi-proficient with sutures,” Jim said. “Aren’t most sutures pretty old school?” 

Leonard shrugged.

“Never forget your roots,” he said. “And besides, we still use them, just in the microfiber version. I figured old school synthetic ones would be easier for her to wrangle.” 

Johanna ran back out of his bedroom, shoes on and backpack slung on her shoulder. 

“Daddy I’m ready!”

“Awesome, Junebug. Say bye to Uncle Jim before we leave.” 

“Bye Uncle Jim!”

“Bye JoJo. I’ll see you and your daddy at lunch, okay?” 

“Okay!”

Leonard walked into Advanced Xenoimmunology a few minutes early, so he and Jo were immediately descended upon by his classmates, who had all decided that Jo was a communal baby sister. Most of the students in the class were fourth year med students who had decided to take an elective, as well as some residents who had transferred into Starfleet, like himself. 

“Daddy, can I sit with Alandra today?” Johanna asked. 

“Yeah of course. Just remember to be polite and sit quietly when the teacher is talkin’, okay?” 

“I will,” said Johanna, before turning and following the third year Bolian resident to her seat. She had bonded with Alandra after she had babysat for her when Leonard had been called in to cover an emergency situation involving a first year Andorian cadet in a hand-to-hand class. 

After meeting Jim and Gaila for lunch, he took Johanna to the sim lab, where he had to set up for the class. He wasn’t technically teaching it, but Kamau had insisted that he run the class while he supervised. Leonard was a fifth year resident after all, getting ready to take his boards at the end of the year before he graduated from the Academy, so he needed to get used to teaching in classroom settings - according to Kamau. 

As it was, Leonard did end up teaching the lab while Kamau introduced Johanna to microfiber sutures and how to work with them. 

“McCoy, you should watch yourself. Otherwise your daughter is going to take your job,” he told him at the end of the lab while the students filed out.

“Oh, I’m countin’ on it,” Leonard grinned. “We start ‘em young in Georgia.” 

“I’ll keep an eye out for her application,” laughed Kamau. He saluted Johanna. “See you later, Dr. McCoy.”

“Thank you Dr. Kamau,” she said. “See you later!” 

Kamau said goodbye to Leonard before they went their separate ways, him back to the hospital and Leonard and Johanna back to the apartment. 

Jim was nowhere to be found when they got back, but that wasn’t too surprising: he did know when to actually apply himself sometimes. For all his vicious ribbing of Jim, Leonard knew he really was an extremely smart, caring, sweet guy. He was just an extrovert to the extreme, and the ADHD certainly helped that along. They’d had a little fling the second semester of their first year, before they both decided that it would be a bad idea, and they worked better as best friends anyway. Now, Leonard was occasionally seeing a third year ortho resident named Katie, and Jim was hooking up with Gaila. 

Jim didn’t get back to their place until after Johanna had gone to sleep, finding Leonard idly watching the holoscreen with his xenoimmunology assignment on the coffee table in front of him. 

“Give up on homework, old man?” Jim asked, sitting down on the couch next to him and offering him a beer he’d snatched out of the fridge. 

“I’m not old, Jim, you’re just a baby,” he replied, taking the bottle. “But yeah. I’m just not feelin’ it tonight.” He took a swig. “Where’ve you been?” 

“Studying tactical specs,” Jim answered. “And I had to finish a paper for my ethics class. I want to give the  _ Kobayashi Maru _ a run for its money.” 

“You do know the point of the test, right?” Leonard asked. 

“Of course I do, but it’s a cheat, isn’t it?” Jim answered. “I’ll find a way, I’m sure of it. I don’t like ‘no-win scenarios.’” 

“I can’t say that I blame you, honestly. Personally, I would rather have a captain who tries everythin’ than one who just goes belly-up right away. I’m not lookin’ to die in the cold, dark vacuum of space because there was nothing that could be done.” 

“You should, just for the irony of it,” Jim grinned. “The great, aviophobic Leonard McCoy, dying in a great, big, flying spaceship.” 

Leonard shoved him in the shoulder. 

“You shut your whore mouth, Farmboy. I’ll make sure to come back and haunt you if that happens.” 

Jim raised his own bottle. 

“I’ll hold you to that, Bones. To the  _ Maru _ ?” 

Leonard clinked their bottles together.

“To the  _ Maru _ .”

**Author's Note:**

> Bones is 28 the first time we meet him in AOS, by the way. 
> 
> This idea really came out of left field for me, but oh man am I glad it did. Full disclosure, I'm not a doctor or a medical student. I'm not even going into human medicine (VetMed people where you at?). I'm getting some info from the amount of times I've watched ER and Grey's Anatomy, as well as the doctors I watch on YouTube, so I do not claim to be completely accurate. Anyway, I think this one of my favorite things I've written in a while.


End file.
